AirCare 4 · 18 min · rotor

Pregnant trauma — 31 weeks

PaCO₂ 30–34 physiology · 6 mL/kg ARDSNet · Pplat ≤30 · ΔP ≤14 · SpO₂ 92–96 · PaCO2 30–34

Load card puts the starting breath on the box. Connect starts the clock. End whenever you want.

31-year-old, G2P1 at 31 weeks, restrained passenger, T-bone at 45. 0.

Rest of the scene

Fundus at the xiphoid. Left uterine displacement on the stretcher.

Handoff

Two patients. She needs 6 mL/kg and a higher minute ventilation than a non-pregnant adult — progesterone already kept her PaCO2 in the low 30s. Do not park her at 40 and call it lung protection. Avoid hypocapnia that starves the placenta, and do not crush venous return with heroic PEEP.

3 objectives
  1. 1

    PaCO2 ~30–34 — her pregnant baseline

    Normal 40 is a relative hypoventilation in the third trimester.

  2. 2

    6 mL/kg PBW, Pplat ≤30, ΔP ≤14

    Use her height, not the gravid weight. IBW is not 94 kg.

  3. 3

    MAP ≥70 and keep LUD

    Aortocaval compression plus high Paw = two pale patients.

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